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Professionals Featured Resources » Become a Member About the AAAAI Careers in A/I Allied Health Articles of Interest New Research from the JACI Research for Patients Job Placement Center Pay for Performance (P4P) Webcast Allergy, Asthma & Immunology Education and Research Trust (ART) Professionals Contact Medical Students Medical Residents Fellows-in-Training Training Programs Referral Guidelines Allergy/Asthma Medication Guide Quality of Life Resources Pierson Program Breakthroughs in Bioscience AAAAI Initiatives/Programs/Education ST*AR Program AAAAI Assembly overview Allied Health Federation of the RSLAAI Societies International Military Allergy New Allergist/Immunologist Assembly Program Directors		• Primary Care Summary - New • View Referral Guidelines supplement • Referral Guidelines, when to refer to an allergist/immunologist PowerPoint Presentation • Order a copy of the Referral Guidelines supplement   TOPICS Overview Allergic bronchopulmonary aspergilllosis (ABPA) Anaphylaxis Asthma Asthma Diagnosis Environmental diagnosis and management - New Asthma Treatment: Immunotherapy - New Asthma Treatment: Preventing Morbidity Asthma Treatment: Preventing Mortality - New Asthma Treatment: Adherence Occupational Asthma - New Conjunctivitis Cough Dermatitis Atopic -- New Contact - New Drug Allergy - New Food Allergy Hypersensitivity Pneumonitis Insect Hypersensitivity Occupational Diseases - New Primary Immune Deficiency Rhinitis/Rhinosinusitis Rhinitis Sinusitis Urticaria/Angioedema How the Allergist/Immunologist Can Help: Consultation and Referral Guidelines Citing the Evidence Introduction Allergic disease affects more than 50 million people in the United States, and is the fifth leading cause of chronic disease in the United States. Allergic rhinitis alone leads to approximately 16.7 million office visits to health care providers each year, while asthma related visits to the emergency department is 2 million each year, with another 465,000 asthma-related hospitalizations. Indirect costs from asthma are reported to be more than $8 billion. Allergies and asthma caue unnecessarey deaths each year: about 150 people in the United States die from food-related anaphylaxis, another 40 from insect stinging anaphylaxis. Asthma leads to about 5,000 deaths each year. For many of these patients, working with an allergist/immunologist can assist them in managing their disease. However, there are not enough allergist/immunologists to treat all patients who have allergic diseases. This Referral Guideline developed by the American Academy of Allergy, Asthma and Immunology is designed to assist patients and health care professionals in determining when referral to an allergist/immunologist is needed, which may be a single or limited consultation, lead to co-management between a primary care provider and an allergist/immunologist, or require ongoing specialty care by the allergist/immunologist. Providing information based on evidence to assist patients and health care providers in the decision-making process should benefit not only the individuals but our health care system as a whole. The evidence included in this guide is based on: Diagnostic evidence: tests performed or interpreted by allergist/immunologists facilitate diagnosis Direct outcome evidence: evidence that intervention by an allergist/immunologist improves outcomes Indirect outcome evidence: evidence that interventions performed by allergist/immunologists improve outcomes (evidence to support established pharmacologic management will generally not be reviewed) This document includes specific referral guidelines for 14 categories of allergic diseases, along with the rationale for the referral, scientific references and the type of evidence provided. The categories are listed alphabetically for easy navigation and do not refer to prevalence of the individual disease. An allergist/immunologist is a physician certified in either internal medicine or pediatrics, who has completed an additional two years of training in allergy and immunology at an accredited training program and passed the examination given by the American Board of Allergy and Immunology (ABAI). The allergist/immunologist is uniquely trained in: Allergy testing (skin, in-vitro) History-allergy test correlation Bronchoprovocation testing (e.g. exercise, methacholine) Environmental control instructions Inhalant immunotherapy Immunomodulator therapy (e.g. anti-IgE, IVIG) Venom immunotherapy Food and drug challenges Drug desensitization Evaluation of immune competence Education (disease, medications, monitoring) Management of chronic or recurrent conditions where allergy is not always identified: rhinosinusitis, conjunctivitis, asthma, cough, urticaria/angioedema, eczema, anaphylaxis The American Academy of Allergy, Asthma & Immunology is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals, and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has nearly 6,000 members in the United States, Canada and 60 other countries.
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